The Washington Post reported last week that Duke University had launched a patient portal that will allow patients "to pay medical bills, schedule doctor appointments and eventually view their personal medical histories". (A more technical article is available at ebizQ.)

I'm usually a little bit past cynical when I hear the word "eventually", but I was reminded of this story this morning so I dug around and found out two things I thought were pretty neat.

One, "eventually" in this case means two months! Why they didn't just wait two months and launch a full service I don't know, but still, if it comes together that's half a million people with free access to their medical history. Very, very cool.

Secondly, I was struck by the third option on the home page, after "Request an Appointment" and "Manage Your Account" there's a link that reads "Visit 'Payment History' for information you need if you're itemizing health care expenses on your taxes".

I'm eagerly awaiting the day my medical history is as automated and accessible as my credit history, and it's smart communications like the above that make the data that much more utile and customer-friendly.

It's a shining example that it's not software that makes the system, it's the people implementing that make the system; and people who want to work with touchy-feely open, standards-based systems tend to produce touchy-feely services that the average user can enjoy and gain from. Flickr is a great example of this, a service that was built by people with love in their hearts, not their three-month review.

I keep on thinking that yes, health care has lagged in IT adoption, especially Web services; but then again, now that it's on the table and people are spending money, we have this amazing opportunity to do it right the first time!

The whole thing runs on IBM's WebSphere software, a standards-based middleware infrastructure that basically takes older systems and wedges Web services between them to get more out of them than was previously gettable. IBM, of course, is at the forefront of Open Document Format, another standard that will seriously impact health information exchange for the better.

Duke itself has representation on the OASIS International Health Continuum Technical Committee which all adds up to a very open, standards-oriented electronic health record that goes way beyond billing and labs and could truly immerse the patient in their role as an informed, advocative consumer.

It probably also helped that IBM's vice president of SOA and WebSphere strategy, Sandy Carter, is a graduate of Duke University.

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My employer is compensated through funding to provide analytical research, technology solutions, and Web-based public and private health care performance reports by the State of New York, the State of Illinois, the Centers for Medicare & Medicaid Services, the Agency for Healthcare Research and Quality, the Commonwealth Fund and Bridges to Excellence. I am not being compensated by any of these organisations to create articles for or make edits to this Web site or any other medium; and all posts authored by me are as an individual and do not represent my employer or the agencies I work for.